To the Editor: Dr Flores and colleagues1 cited an article2 about
the translation of the Spanish version of the Consumer Assessment of Health
Plans Study (CAHPS) 1.0 survey and summarized it by saying that "initial Spanish
translations were too awkward, culturally inappropriate, insufficiently idiomatic,
frequently lacking in conceptual equivalence, and at an inappropriately high
reading level." We wish to clarify that the focus of that article was not
only to outline some of the issues and problems with the Spanish version of
CAHPS 1.0 but also to explain some of the measures that were taken to address
these issues, including conducting cognitive interviews and a small field
test. The instrument was revised (CAHPS 2.0)3 according
to this information by using alternative Spanish wording that was more colloquial,
which improved the conceptual equivalence between the Spanish and English
versions of this instrument.